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The implications of enterococci for the intensive care unit
Indranil Chatterjee1, Jonathan R Iredell, Marion Woods
1Department of Intensive Care Medicine, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia. ic94@rediffmail.com
Summary
Enterococcus species can cause severe ICU infections, leading to higher mortality and treatment failure. Antibiotic coverage is recommended for high-risk patients, particularly those with peritonitis or sepsis.
Area of Science:
- Infectious Diseases
- Critical Care Medicine
- Microbiology
Background:
- Enterococcus species are common gut bacteria with traditionally low virulence.
- However, they can cause severe nosocomial infections, especially in immunocompromised individuals.
- Their role as primary pathogens in intra-abdominal infections is debated, but associated mortality is increasing.
Purpose of the Study:
- To review evidence on the pathogenicity and virulence of Enterococcus species in intensive care units (ICUs).
Main Methods:
- A comprehensive MEDLINE search was conducted for relevant studies and articles on Enterococcus species.
Main Results:
- Enterococcus species, while typically commensal, are increasingly implicated in life-threatening ICU infections.
- Enterococcal peritonitis is linked to increased mortality rates.
- Despite potentially low prevalence in some regions, these infections demonstrate higher rates of treatment failure.
Conclusions:
- Enterococcal infections in ICUs are associated with significant treatment failure and mortality.
- Prophylactic enterococcal antibiotic coverage is advised for specific high-risk patient groups.
- Recommendations include immunocompromised patients, those with peritonitis and specific comorbidities, severe abdominal sepsis, and persistent intra-abdominal collections.
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